Provider Demographics
NPI:1245339167
Name:JOHNSON, JOAN MARIE (MA LMHC)
Entity type:Individual
Prefix:MRS
First Name:JOAN
Middle Name:MARIE
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:MA LMHC
Other - Prefix:MS
Other - First Name:JOAN
Other - Middle Name:MARIE
Other - Last Name:MICHAEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1223 22ND ST
Mailing Address - Street 2:
Mailing Address - City:SNOHOMISH
Mailing Address - State:WA
Mailing Address - Zip Code:98290
Mailing Address - Country:US
Mailing Address - Phone:360-568-4981
Mailing Address - Fax:
Practice Address - Street 1:4807 196TH SW
Practice Address - Street 2:SUITE 100
Practice Address - City:LYNNWOOD
Practice Address - State:WA
Practice Address - Zip Code:98036-6409
Practice Address - Country:US
Practice Address - Phone:425-774-4269
Practice Address - Fax:425-744-1216
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH00009720101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health